Impact of remote magnetic catheter navigation on ablation fluoroscopy and procedure time.
BACKGROUND
Remote magnetic catheter navigation (RCN) is gaining acceptance in clinical cardiac electrophysiology, but details regarding how RCN affects procedure execution are not well characterized.


METHODS
From January 1, 2005, to November 30, 2007, 721 cases were retrospectively analyzed and compared. Of these, 127 used RCN and 594 used manual catheter navigation (MCN). Data including procedure time, fluoroscopy time, ablation catheter, procedural success, and complications were extracted from our procedure database and compared between RCN and MCN.


RESULTS
RCN use significantly decreased fluoroscopy time for atrial fibrillation (AF) ablation (-29 minutes, P < 0.001), atrioventricular nodal reentrant tachycardia ablation (-14 minutes, P < 0.001), and atrioventricular reentrant tachycardia ablation (-18 minutes, P = 0.045). While RCN significantly increased mean procedure time for AF (+36 minutes, P = 0.003) and atypical atrial flutter cases (+116 minutes, P = 0.016), RCN AF procedure time diminished with increasing number of cases performed. Two cases of tamponade occurred during AF ablation using MCN (2.2%, 2 of 91 cases). No tamponade occurred during all 75 AF ablations with RCN.


CONCLUSIONS
RCN can reduce fluoroscopy time and may reduce complications during catheter ablation. While it may increase total procedure duration, procedure times decrease with increasing operator experience. (PACE 2008; 31:1399-1404).
Kim
Albert M
AM
University of California, San Francisco, California, USA.
Turakhia
Mintu
M
Lu
Jonathan
J
Badhwar
Nitish
N
Lee
Byron K
BK
Lee
Randall J
RJ
Marcus
Gregory M
GM
Tseng
Zian H
ZH
Scheinman
Melvin
M
Olgin
Jeffrey E
JE
D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods* / Q000706:statistics & numerical data*; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008280:Magnetics / Q000379:methods; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome